Michał Wiechetek

Impact of beliefs about pain control on perceptions of illness in surgical patients.

OBJECTIVES Adequacy of pain management in surgical patients is a major contributor to overall treatment outcomes and positive illness perceptions. However, it may be subjectively predetermined by a patients beliefs about pain control. This study assesses the relationships between beliefs about pain control and perceptions of illness in thoracic surgical patients. MATERIALS AND METHOD A total of 135 patients (72 women and 63 men; mean age 58.4±14.25y) were enrolled in the questionnaire study based on the Beliefs about Pain Control Questionnaire (BPCQ) by S. Skevington and the Multidimensional Essence of Disease and Illness Scale (MEDIS) by J. Sak. Analyses were conducted with use of the k-means clustering technique and one-way ANOVA. RESULTS Applied classification revealed 3 different clusters of patients with regard to their beliefs about pain control: 1) weak, undifferentiated pain control; 2) intensified influence of chance pain control; 3) strong undifferentiated pain control. Significant differences in illness perceptions between clusters were disclosed in 3 MEDIS dimensions: self-realization constraints (F=4.70; p=0.01; 1 vs. 3), mental dysfunction (F=3.44, p=0.04; 1 vs. 3) and physical dysfunction (F=3.10, p=0.05; 1 vs 2). Patients in cluster 3 demonstrated a greater feeling of self-realization constraints and mental dysfunction than in cluster 1, whereas patients in cluster 2 perceived physical dysfunction as a greater distress than those in cluster 1. CONCLUSIONS Beliefs about pain control significantly influence illness perceptions, and thus may affect the results of treatment in surgical patients. Psychological modelling of beliefs about pain control may offer a valuable way to improve overall clinical outcomes.